Myocardial ischemia and infarction analysis and recognition are needed for the management of cardiac disorders and irregularities, which may be caused by a lack of blood and oxygen in the heart tissue and cells. Usually, surface ECG (electrocardiogram) signal analysis based on waveform morphology and time domain parameters is used for myocardial ischemia and infarction detection and characterization, such as of ST segment or T wave changes (repolarization). However known systems lack efficient quantitative methods for myocardial status detection and characterization, including determination of severity and quantitative characterization of ongoing myocardial ischemia events with chest pain. Additionally, known systems for cardiac ischemia and infarction identification and analysis using ECG signals are subjective and need extensive expertise for accurate pathology interpretation, proper cardiac rhythm management and early detection of myocardial ischemia.
CAD (Coronary Artery Disease) and heart-related problems and cardiac arrhythmias are often fatal. A 12-lead electrocardiogram (ECG) and multi-channel intra-cardiac electrograms (ICEG) are a diagnostic reference standard for evaluating cardiac rhythm and events. Known waveform morphologies and time domain parameter analysis, such as of a P wave, QRS complex, ST segment and T wave, are used for cardiac arrhythmia monitoring and identification, e.g., of atrial fibrillation (AF), myocardial ischemia (MI) and ventricular tachycardia/fibrillation (VT/NT). Known system signal calculation and related analysis usually fails to localize a malfunction and identify a harmful trend of cardiac events (e.g. in myocardial ischemia and infarction), such as cardiac pathology irregularity stages and arrhythmia occurrence.
Inaccurate and subjective ECG and ICEG evaluation and diagnosis may impede cardiac rhythm management and emergency treatment. Known clinical diagnosis for myocardial ischemia and infarction detection are based on ST segment voltage deviation for ischemia event detection (e.g., 0.1 mV elevation of ST segment is a clinical standard used for myocardial ischemia (MI) detection). However this standard only works for surface ECG signals and not for intra-cardiac electrograms (ICEG signals) and an ST segment deviation (voltage) cannot be utilized as a quantitative method for myocardial ischemia severity diagnosis and characterization.
Known clinical methods for myocardial ischemia event detection and evaluation rely on a repolarization procedure and identifying ST segment and T wave morphology changes, for example. Further known clinical methods for myocardial ischemia event diagnosis fail to combine diagnosis of both the depolarization and repolarization procedures, especially the timing, frequency and energy changes of the procedures. Known methods for MI analysis focus on an event and qualitative detection and evaluation of MI occurrence and ischemia event detection systems may cause false alarms due to single parameter analysis, such as analysis involving magnitude of ST segment measurement. A system according to invention principles addresses these deficiencies and elated problems.